Nutritional Treatment of Overweight Adolescents with Cardiovascular Risk Factors

具有心血管危险因素的超重青少年的营养治疗

• 批准号: 7485099
• 负责人: Sarah D DE FERRANTI
• 金额: $ 15.93万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7485099
• 关键词: Adhesions; Adolescent; Adult; Affect; Age; Area; Atherosclerosis; Attention; Beta Cell; Blood Coagulation Disorders; Blood Platelets; Blood Pressure; Blood Vessels; Body Composition; Body Weight decreased; C-reactive protein; Caliber; Cardiology; Cardiovascular system; Cell Adhesion Molecules; Cell physiology; Central obesity; Child; Childhood; Clinical Trials; DEXA; Development Plans; Diastolic blood pressure; Diet; Dyslipidemias; End Point; Endocrinologist; Endothelium; Energy Intake; Epidemic; Fat-Restricted Diet; Fibrinogen; Functional disorder; Goals; High Blood Pressure; High Density Lipoproteins; High Prevalence; Hypertension; Inflammation; Inflammatory; Intercellular adhesion molecule 1; Intervention; Invasive; Knowledge; Leptin; Life Style; Lipids; Measures; Mediating; Mentorship; Metabolic; Metabolic Diseases; Metabolic syndrome; Modification; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Outcome; Outcome Measure; Overweight; P-Selectin; Pediatrics; Peripheral; Phenotype; Physiologic pulse; Physiology; Plasma; Plasminogen Activator Inhibitor 1; Prevalence; Prevention; Prevention strategy; Preventive; Protocols documentation; Pulse taking; Randomized; Research; Research Design; Research Personnel; Sampling; Serum; Surface; Testing; Tumor Necrosis Factor-Beta; United States; Universities; Week; adiponectin; blood glucose regulation; brachial artery; cardiovascular disorder risk; cardiovascular risk factor; career; cytokine; design; experience; feeding; improved; indexing; instructor; insulin sensitivity; interest; intravenous glucose tolerance test; lipoprotein triglyceride; nutrition; pre-clinical; radial artery; receptor; saturated fat; tonometry

DESCRIPTION (provided by applicant): The applicant, Dr. Sarah de Ferranti, is a pediatric cardiologist and Instructor in Pediatrics at Harvard University. Her long term goal is to become an independent clinician researcher in the assessment of vascular dysfunction and reduction of cardiovascular risk in children. Dr. de Ferranti has a longstanding interest in prevention; the pediatric obesity epidemic has focused her attention on adolescents with cardiovascular risk factors typical of the adult metabolic syndrome. Children with cardiovascular risk factors are likely to have cardiovascular and metabolic disease as adults. The proposed career development plan is necessarily multi-disciplinary, incorporating aspects of inflammatory physiology, nutritional lifestyle modification, and the conduct of an interventional clinical trial. Importantly, she will become proficient in vascular functional testing as a way of assessing pre-clinical atherosclerosis, allowing her to combine two areas of expertise rarely seen together, pediatric preventive cardiology and non-invasive vascular testing. Under the mentorship of Dr. David Ludwig, a pediatric endocrinologist experienced in obesity and nutrition, and Dr. Jane Newburger, a pediatric cardiologist with expertise in preventive cardiology and research, the applicant will investigate the effect of two nutritional strategies on cardiovascular risk factors. Using a feeding study design, the applicant will test the hypothesis that dietary strategy, independent of weight loss, affects cardiovascular risk factors. The protocol randomly assigns 46 overweight adolescents age 12-19 years with cardiovascular risk factors typical of the metabolic syndrome to receive either a low-fat diet or a low-glycemic load diet designed to induce a 5% weight loss over a period of 8 weeks. The primary outcome will be changes from baseline in insulin sensitivity as measured with an intravenous glucose tolerance test; other outcomes will include inflammation, coagulopathy, dyslipidemia, blood pressure, central obesity and body composition by DEXA. A secondary hypothesis to be tested is that vascular function measured by brachial artery reactivity and peripheral arterial tonometry will improve with weight loss, with larger changes from baseline in the low glycemic load group than the low fat diet. To our knowledge, this would be the first well- controlled feeding study to be conducted in overweight adolescents. The high prevalence of pediatric obesity in the United States makes greater understanding of the pediatric cardiovascular consequences essential.

描述（由申请人提供）：申请人Sarah de Ferranti博士是哈佛大学儿科的儿科心脏病专家和讲师。她的长期目标是成为评估血管功能障碍和儿童心血管风险降低的独立临床研究者。 De Ferranti博士对预防长期以来兴趣；小儿肥胖症的流行将她的注意力集中在成人代谢综合征典型的心血管危险因素的青少年上。患有心血管危险因素的儿童可能患有心血管和代谢疾病。拟议的职业发展计划必然是多学科的，结合了炎症生理学，营养生活方式的改变以及进行介入临床试验的各个方面。重要的是，她将精通血管功能测试，以评估临床前动脉粥样硬化，使她能够将很少见的两个专业知识结合在一起，小儿预防性心脏病学和非侵入性血管测试。在儿科内分泌学家戴维·路德维格（David Ludwig）博士的指导下，肥胖和营养学经历过，以及具有预防性心脏病学和研究专业知识的儿科心脏病专家简·纽伯格（Jane Newburger），申请人将研究两种营养策略对心血管危险危险因素的影响。使用喂养研究设计，申请人将检验以下假设：饮食策略与体重减轻无关，会影响心血管危险因素。该方案随机分配了46岁的超重青少年12-19岁的心血管危险因素，代谢综合征的典型危险因素可以接受低脂饮食或低血糖负荷饮食，旨在在8周内诱导5％的体重减轻。主要结果将是通过静脉葡萄糖耐受性测试测量的胰岛素敏感性中的基线变化。其他结果将包括炎症，凝血病，血脂异常，血压，中枢肥胖和人体组成，由DEXA。要测试的次要假设是，通过肱动脉反应性和外周动脉渗透指标测量的血管功能将随体重减轻而改善，而低脂肪饮食的基线比基线的变化大于低脂肪饮食。据我们所知，这将是首次在超重青少年中进行的良好控制喂养研究。在美国，小儿肥胖症的高流行使得对小儿心血管后果的理解更加了解。